Provider Demographics
NPI:1003303835
Name:LAS OVAS ALF CORP.
Entity Type:Organization
Organization Name:LAS OVAS ALF CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMIN.
Authorized Official - Prefix:
Authorized Official - First Name:NEUDIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PEREZ PUPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-856-7009
Mailing Address - Street 1:1214 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5430
Mailing Address - Country:US
Mailing Address - Phone:561-513-9149
Mailing Address - Fax:561-530-7779
Practice Address - Street 1:1214 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5430
Practice Address - Country:US
Practice Address - Phone:561-513-9149
Practice Address - Fax:561-530-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-17
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL13137310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility